SCI Rep: Relationship between dairy intake and metabolic health in overweight and obese adolescents

Background: The World Health Organization (WHO) identifies overweight/obesity in children and adolescents as one of the most serious public health challenges of the
twenty-first century.
The prevalence of overweight/obesity among children and adolescents has increased
significantly worldwide since 1980.
Pooled results from studies of 31.
5 million people aged 5-19 years from 200 countries show that the global age-standardized prevalence of obesity is increasing
for both men and women worldwide.
Adolescent overweight/obesity places a significant burden on affected individuals, their families and health care systems, especially in low- and middle-income countries with
limited resources.
Adolescent overweight is often associated with serious complications such as hypertension, dyslipidemia, insulin resistance, and fatty liver disease, all of which increase the risk of
future cardiovascular disease (CVD), type 2 diabetes, and subsequent premature death.
Therefore, effective management of overweight and obesity and their associated complications in this age group is essential
.

Despite the above relationship, cardiometabolic risk factors did not occur
in some clinically obese individuals known as metabolically healthy obesity (MHO) individuals.
There is no consensus on the definition of MHO and the different definitions, therefore, different prevalence of this disease is proposed in the literature
.
However, it is clear that patients with MHO exhibit desirable metabolic profiles characterized by increased insulin sensitivity, lipid and blood pressure, and lower mortality
.
A combination of genetic and lifestyle-related factors, such as dietary intake and physical activity, plays a role
in the etiology of this disease and in preventing the development of metabolically unhealthy obesity (MUO) disease.
For example, previous surveys have reported that healthy eating patterns that consume more fruits and vegetables, less fat and soft drinks are associated with
MHO.

Limited previous studies have investigated the relationship between dairy intake and adolescent metabolic health; There is no consistency
between existing results.
A cohort study of 531 participants aged 6-18 years without metabolic syndrome (MetS) at baseline showed a reduced
risk of metabolic syndrome in those who consumed more dairy products, mainly low-fat milk and yogurt.
Abreu et al.
also showed that higher milk intake was associated
with lower cardiometabolic risk scores in adolescents.
However, they found no link
between total intake of dairy, yogurt, or cheese and this score.
Conversely, the results of Mohammadi et al.
's cross-sectional study of 785 adolescents aged 10-19 years did not support a link between
dairy intake and metabolic syndrome or its components.
To our knowledge, no previous studies have proposed a relationship between
dairy intake and adolescent MHO/MOO status.

Objective: This study evaluated the relationship between
dairy intake and metabolic health in overweight/obese Iranian adolescents.

Methods: Overweight/obese adolescents (n = 203101 boys and 102 girls) participated in this cross-sectional study
.
Dietary intake was assessed
using a valid 147-item food frequency questionnaire.
Measure anthropometric index, blood pressure, fasting blood glucose, insulin, and lipids
.
Participants were divided into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO)
based on the combination of IDF and Homeostatic Model for the Evaluation of Insulin Resistance (HOMA-IR) criteria and IDF with steady-state model criteria.
The incidence of MOO based on IDF and IDF/HOMA-IR definitions was 38.
9% and 33.
0%,
respectively.

Results: In a fully adjusted model, participants with the highest third of dairy intake had a 61% lower chance of developing MOO according to IDF criteria (OR = 0.
39, 95% CI 0.
15–0.
99).

According to the definition of IDF/HOMA-IR in the maxima-adjusted model (OR = 0.
44, 95% CI 0.
17–1.
16), higher dairy intake was associated
with a non-significant lower risk of MOO.
Stratified analysis by sex and body mass index showed that the association was stronger
in girls and overweight subjects.
In addition, higher intake of low-fat dairy products was associated with the likelihood of lower MUO, while higher intake of high-fat dairy products was associated
with increased odds of MOO.

Fig.
1 Prevalence of MUO based on energy-adjusted tertiary of dairy intake based on IDF(A) and IDF/HOMA-IR definitions (B
).

Table 1 Multivariate adjusted odds ratio (OR) and 95% confidence interval (CI)
for MUO energy-adjusted dairy intake.
All values are odds ratios and 95% confidence intervals
.
Model 1: Adjusted
for age, sex, total energy intake, and fat intake (energy percentage).
Model 2: In addition, adjustments are made
based on physical activity and socioeconomic status (parental education, parental work, number of family members, car in the home, computer/laptop, private room and travel).
Model 3: Make additional adjustments
based on body mass index (body mass index).

Table 2 Multivariate Adjusted Odds Ratio (OR) and 95% Confidence Interval (CI) for MOO Stratified by body mass index classification
by third quantile of energy-adjusted dairy intake1.
All values are odds ratios and 95% confidence intervals
.
Model 1: Adjusted
for age, sex, total energy intake, and fat intake (energy percentage).
Model 2: Additional adjustments
were made based on physical activity and socioeconomic status (parental education, parental work, number of family members, car in the home, computer/laptop, private room, and travel).

Table 3 Multivariate correction odds ratios (OR) and 95% confidence intervals (CI) adjusted for energy intake for MOO, stratified
by sex.
All values are odds ratios and 95% confidence intervals
.
Model 1: Adjusted
for age, sex, total energy intake, and fat intake (energy percentage).
Model 2: Additional adjustments
were made based on physical activity and socioeconomic status (parental education, parental work, number of family members, car in the home, computer/laptop, private room, and travel).
Model 3: Make additional adjustments
based on body mass index (body mass index).

Table 4 Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) for MOO adjusted for low- and high-fat dairy product intake
.
All values are odds ratios and 95% confidence intervals
.
Model 1: Adjusted
for age, sex, total energy intake, and fat intake (energy percentage).
Model 2: In addition, adjustments are made
based on physical activity and socioeconomic status (parental education, parental work, number of family members, car in the home, computer/laptop, private room and travel).
Model 3: Make additional adjustments
based on body mass index (body mass index).

Conclusions: This community-based, cross-sectional study showed that higher dairy intake was associated
with significantly lower incidence of MOO among Iranian adolescents, especially girls and overweight subjects.

Original source:

Tirani SA, Mirzaei S, Asadi A, et al.
Dairy intake in relation to metabolic health status in overweight and obese adolescents.
Sci Rep 2022 Nov 01; 12(1)